An update on repurposed medications for the treatment of drug-resistant tuberculosis

ABSTRACT

Introduction: Drug-resistant forms of tuberculosis are a major public health problem with a serious global impact. Although there have recently been two new drugs introduced for the treatment of drug-resistant TB (bedaquiline and delamanid), the current therapeutic armamentarium is limited. Because treatment of drug-resistant TB requires the use of a multidrug-regimen, there has been growing interest in the use of antibiotics developed for other infectious pathogens but that have shown efficacy in the treatment of TB.

Areas covered: This paper will review these ‘re-purposed’ agents – including the beta-lactams, clarithromycin, clofazimine, the fluoroquinolones, and linezolid – with a focus on their efficacy, safety, and pharmacokinetic properties.

Expert commentary: There is growing evidence on the efficacy and safety of repurposed drugs for the treatment of drug-resistant TB, supporting their program-wide inclusion in treatment regimens as recommended in revised WHO guidelines. However, additional work is needed to define optimum dosing as well as describe their role in regimen optimization.

KEYWORDS:

• Tuberculosis
• drug resistance
• repurposed drugs
• beta lactams
• clofazimine
• clarithromycin
• linezolid
• fluoroquinolones

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Additional information

Funding

This paper was not funded.